Instructor Michelle Earixson-Lamothe
May 17, 2014
Renal Failure is a common condition that could also be described as Acute renal failure (ARF) or Chronic renal failure(CRF), both conditions occur when there is a loss of kidney function. Kidney disease or renal failure is the ninth leading cause of death in the United States (Pradeep ,2014). Specifically, acute renal failure is characterized by the kidney’s sudden inability to filter blood, excrete wastes, concentrate urine, preserve electrolytes, and sustain fluid balance which leads to many problems in the human body. Acute renal failure alone is a frequent clinical problem, especially in the intensive care unit, where according to Clin (2004), “is associated with mortality of between 50% and 80%” (p5). As for the pathophysiology part of acute renal failure inadequate blood supply to an organ, ischemia plays a large role. If a person has ischemia for more than 2 hours it can result in irreversible damage to the kidneys. Significant reduction in glomular filtration rate (GFR) is a result of ischemia, activation of the renin-angiotensin system, and tubular obstruction by cellular debris. As nephrotoxins damage the tubular cells and the same cells are lost through necrosis, the tubules become more permeable which results in filtrate absorption and a reduction in the nephrons ability to eliminate waste.
There are three causes of renal failure which include prerenal, intrarenal, and postrenal. Prerenal disorders are before the nephron and are used to refer to any disruption on the cardiovascular side of the nephron. Anything that originates in the circulatory blood supply of the nephron that impairs its function is classified as prerenal. In Intrarenal disorders the problem arises from within the nephron tubules themselves, at some point from the proximal tubule to the collecting duct. It is difficult to imagine damage so specific as to damage the inner nephron without affecting either end unless attention is given to bacterial toxins and accidentally ingested materials, such as pesticides, herbicides, heavy metals, antifreeze, certain cleaning fluids, and nephrotoxic drugs (Bowman O. D, Jr.). Postrenal disorders are those that initiate in the urinary tract from the nephrons of the kidney. These types of kidney disorders can involve the renal pelvis, the ureters or the bladder and urethra.
If a patient’s signs and symptoms suggest that he or she has acute renal failure the primary caregiver might suggest tests and procedures verify the diagnosis. Some of those tests include urine output measurements which would help the physician determine the cause of the kidney failure. Another test that could be taken is a urinalysis which may show abnormalities that suggest kidney failure. Having a blood test that shows rising levels of urea and creatinine which are also measured to kidney function. Different imaging tests such as ultrasound or computerized...